[pedagogue]

Probably in 99% of the cases a generic will be less expensive than a brand name. VA's (and related) can still have brand names, but there needs to be a proven medical reason for them to use a brand name formulary instead of a generic or older med. This is often an issue with other types of meds (like mood stabalizers and anti-psychotics), but they rarely get passed because the data supports the other drugs as more effective....though typically they have more s/e's.

TCAs sometimes get a bad rep. because they are 'older' and they have a diff side effect profile, but they can be quite effective, and not everyone has s/e's.

Effexor is an SNRI. SNRI's are often a second step because they act on both serotonin and on norepinephrine, instead of just serotonin like the SSRIs. If that doesn't work, they'll probably try a TCA next. Each type of drug has their own positives and negatives, and dependent upon your husband's medical history, your doc will figure out what works best in his situation.

-p